Defyingnoodles t1_j3113bx wrote on January 5, 2023 at 8:48 AM

The most convincing explanation for long COVID syndrome to me is that the hyper coagulable state seen in COVID patients is causing tiny, subclinical blood clots. In the brain, this leads to widespread tiny strokes essentially, causing the symptoms of brain fog and reduced cognitive functioning. Female sex as a risk factor makes sense in this case, as higher estrogen levels are associated with increased risk of clotting.

goosegirl86 t1_j318rby wrote on January 5, 2023 at 10:30 AM

Also females who could be on contraception. The pill is known to increase risk of blood clotting (perhaps due to the estrogen? I’m unsure of the reason so don’t wanna guess incorrectly)

Defyingnoodles t1_j32sjcl wrote on January 5, 2023 at 5:47 PM

Bingo! Premenopausal women (higher estrogen levels than post menopausal) who are taking hormonal birth control are at much higher risk of clotting events. The study in this post was conducted mainly in Saudi Arabia, where rates of normal birth control usage are much lower than the US. From a quick control F, they didn’t control for birth control. If not controlled for, I imagine the association between female sex and long COVID would be stronger in the US. I don’t think birth control is a confounded though, as women at baseline have higher risk of blood clots.